Predicting Survival in Pulmonary Arterial Hypertension
Why the study?
What are the independent predictors of 1-year survival in patients with pulmonary arterial hypertension?
Population
2716 patients with pulmonary arterial hypertension enrolled consecutively in the US Registry to Evaluate…
Design
Cohort
Follow-up
1 year
Authors
Discussion
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Member takes
Implication
Supports PAH risk stratification; leaves open prospective validation of the derived formula before guiding therapy.
Key Points
- To identify independent predictors of 1-year survival in patients with pulmonary arterial hypertension and derive a multivariable, weighted risk prediction formula for clinical use.
- Interventional registry study evaluating consecutive participants with pulmonary arterial hypertension enrolled in the US REVEAL registry (N=2716; NCT00370214).
- Multivariable Cox proportional hazards regression and bootstrap validation were conducted using clinical, hemodynamic, and laboratory evaluations to formulate a survival prediction equation.
- Overall 1-year survival from registry enrollment was 91.0% (95% CI, 89.9 to 92.1).
- Mortality was independently predicted by pulmonary vascular resistance >32 Wood units (HR, 4.1; 95% CI, 2.0 to 8.3), portal hypertension (HR, 3.6; 95% CI, 2.4 to 5.4), and functional class IV symptoms (HR, 3.1; 95% CI, 2.2 to 4.4).
- Male sex over age 60 (HR, 2.2; 95% CI, 1.6 to 3.0) and family history of pulmonary arterial hypertension (HR, 2.2; 95% CI, 1.2 to 4.0) also independently predicted increased mortality.
Structured PICO
What are the independent predictors of 1-year survival in patients with pulmonary arterial hypertension?
P
Population
2716 patients with pulmonary arterial hypertension (PAH) enrolled consecutively in the US Registry to Evaluate Early and Long-Term PAH Disease Management (REVEAL)
O
Outcome
1-year survivalhard clinical
A multivariable prognostic equation derived from the REVEAL registry identifies key predictors of 1-year survival in PAH to help individualize therapeutic strategies.
Cite This Study
Benza et al. (2010) studied this question.